(1) The Montana Medicaid Program will reimburse providers of inpatient psychiatric services provided to a youth in a psychiatric residential treatment facility (PRTF) for each patient day, which is consistent with the definition of a PRTF and all other applicable requirements are met.

(2) The Montana Medicaid Program will pay a provider for each Medicaid patient day, the following bundled per diem rate less any third party or other payments. The bundled per diem rate for in-state PRTF services is the lesser of:

(a) the amount specified in the department's Medicaid Youth Mental Health fee schedule, as adopted in ARM 37.85.105; or

(b) the provider's usual and customary charges.

(3) The bundled per diem rate for in-state PRTFs coverage includes the following services:

(a) services, therapies, and items related to treating the psychiatric condition of the youth;

(c) adult mental health center evaluations for transition age youth 17 to 18, to determine whether or not they qualify for adult mental health services and have a severe and disabling mental illness.

(6) The Montana Medicaid Program will reimburse state plan ancillary services in addition to the in-state PRTF bundled per diem rate when these ancillary services are provided by a PRTF or by a different provider under arrangement with the PRTF. The ancillary services provided must be:

For questions regarding the content, interpretation, or application of a specific rule, please contact the agency that issued the rule. A directory of state agencies is available online at http://www.mt.gov/govt/agencylisting.asp.

For questions about the organization of the ARM or this web site, contact sosarm@mt.gov.